title: Mandibular fractures treated with small plates and screws reduce treatment cost.
abstract: OBJECTIVE
  The efficacy of treating mandibular fractures with open reduction and internal fixation (ORIF) using small titanium plates and monocortical screws is well established. The purpose of this study was to determine whether the use of semirigid (small) titanium plates results in lower treatment charges.
  
  
  METHODS
  Consecutive patients with mandibular fractures were randomly allocated to ORIF with small or large titanium plates. The primary predictor variable for this secondary subset analysis was plate size. The primary outcome variable was total treatment charges. Other outcomes included length of stay (LOS), operating room charges, hardware charges, LOS charge, and charges related to the treatment of complications.
  
  
  RESULTS
  A total of 127 consecutive patients were enrolled in the study. Fifty-two patients completed the required 6-week follow-up and had data available for analysis. Adjusted total treatment charges suggested a significant difference, with a mean total treatment charge of $15,308 in the semirigid group and a mean total treatment charge of $16,557 in the rigid group (P = .04). Total treatment charges were 8% higher in the rigid group compared with the semirigid group.
  
  
  CONCLUSIONS
  The findings of this study suggest that the overall charges associated with treating mandibular fractures with ORIF are significantly lower when semirigid plates are used.
authors.affiliation: Associate Professor, Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA. Electronic address: gbouloux@hotmail.com.
authors.forename: Gary F
authors.initials: GF
authors.lastname: Bouloux
authors.affiliation: Former Chief Resident, Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA.
authors.forename: Michael
authors.initials: M
authors.lastname: Demo
authors.affiliation: Resident, Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA.
authors.forename: Justine
authors.initials: J
authors.lastname: Moe
authors.affiliation: Senior Associate, Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA.
authors.forename: Kirk A
authors.initials: KA
authors.lastname: Easley
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates / Q000191:economics; D001863:Bone Screws / Q000191:economics; D016009:Chi-Square Distribution; D003365:Costs and Cost Analysis; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000191:economics* / Q000295:instrumentation / Q000706:statistics & numerical data; D005599:Fractures, Ununited / Q000453:epidemiology; D006801:Humans; D016014:Linear Models; D008297:Male; D008337:Mandibular Fractures / Q000191:economics* / Q000601:surgery*; D008875:Middle Aged; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult